DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Blaser, Mitchell Holt	DOIID	901080	NAIC NPN	17795562

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Casualty	1/4/2016		7/31/2026
Active	Resident	Agent	Property	1/4/2016		7/31/2026
Active	Resident	Surplus Lines Broker	Not Applicable	10/18/2019		7/31/2026
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	AGCS Marine Insurance Company	300403	Agent - Casualty	7/22/2022
Active	AGCS Marine Insurance Company	300403	Agent - Property	7/22/2022
Active	Illinois Casualty Company	1250052	Agent - Casualty	6/3/2024
Active	Illinois Casualty Company	1250052	Agent - Property	6/3/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Risk Placement Services Inc	509419	Agent - Casualty	5/6/2024
Active	Risk Placement Services Inc	509419	Agent - Property	5/6/2024
Active	Risk Placement Services Inc	509419	Surplus Lines Broker - Not Applicable	5/6/2024